What question did this study set out to answer?

To determine whether multifactorial risk factor reduction lowers coronary heart disease incidence and mortality among industrial workforces.

March 1, 1983European Heart Journal

Multifactorial trial in the prevention of coronary heart disease: 3. Incidence and mortality results

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Coronary heart disease (n=49781). Intervention: Multifactorial prevention of coronary heart disease vs. Control. Primary outcome: Fatal CHD + non-fatal myocardial infarction (3.9% reduction, 95% CI -10 to +2).

View Full Paper

Ask AI

Bookmark

Key result

Multifactorial prevention of coronary heart disease resulted in a 3.9% net overall reduction in fatal CHD and non-fatal myocardial infarction (95% CI -10 to +2%).

Why the study?

Does multifactorial community intervention reduce coronary heart disease incidence and mortality in men?

Population

49,781 men across 66 factories in U.K., Belgium, Italy, and Poland (Cracow)

Comparison

Multifactorial prevention of coronary heart… vs Control factories

Design

RCT, Cluster randomization of 66 factories

Discussion

Member takes

Implication

No significant CHD event reduction with multifactorial prevention; challenges modest community interventions and extends evidence for larger risk factor changes.

Key Points

To determine whether multifactorial risk factor reduction lowers coronary heart disease incidence and mortality among industrial workforces.
International cluster-randomized controlled trial allocating 66 factories (N=49,781 men) across the U.K., Belgium, Italy, and Poland (Cracow) to multifactorial risk prevention or control.
Intervention targeted major coronary risk factors including elevated plasma cholesterol, cigarette smoking, overweight, and elevated systolic blood pressure.
Intervention achieved net average risk reductions of 1.2% for cholesterol, 8.9% for daily cigarettes, 0.4% for weight, 2.0% for systolic blood pressure, and 11.1% for overall estimated risk (19.4% in high-risk subjects).
Coronary heart disease mortality was reduced by 7.4% (95% CI, -29% to +15%; 722 cases), and fatal coronary heart disease plus non-fatal myocardial infarction fell by 3.9% (95% CI, -10% to +2%; 1502 cases), with a 15% reduction in men aged 40–49.
Total mortality declined by 2.7% overall, with marked regional differences ranging from a 5% net increase in coronary heart disease in the U.K. to a statistically significant 24% decrease in Belgium (P < 0.05).

Study Design

Type

RCT (n=49,781)

Randomization

Randomized

Multicenter

Yes

Structured PICO

Does multifactorial community intervention reduce coronary heart disease incidence and mortality in men?

Population

49,781 middle-aged men from 66 factories in the U.K., Belgium, Italy, and Poland enrolled in a multifactorial coronary heart disease prevention trial.

Intervention

Multifactorial prevention of coronary heart disease (community intervention)

Comparator

Control factories

Outcome

Coronary heart disease (CHD) deaths and composite of fatal CHD plus non-fatal myocardial infarctionhard clinical

Main Result

Effect estimate: 3.9% reduction (95% CI -10 to +2)

Multifactorial community intervention can reduce major coronary risk factors, with potential benefits on CHD incidence and mortality that correlate with the degree of risk factor reduction.

Limitations

Results for Poland (Warsaw) are not yet complete.

Cite This Study

A 1983 study conducted an RCT in Coronary heart disease (n=49,781). Multifactorial prevention of coronary heart disease vs. Control was evaluated on Fatal CHD + non-fatal myocardial infarction (3.9% reduction, 95% CI -10 to +2). Multifactorial prevention of coronary heart disease resulted in a 3.9% net overall reduction in fatal CHD and non-fatal myocardial infarction (95% CI -10 to +2%).

synapsesocial.com/papers/6a9fede540bc1a697f1debf7 https://doi.org/10.1093/oxfordjournals.eurheartj.a061433

View Full Paper

Ask AI

Bookmark

Implication

No significant CHD event reduction with multifactorial prevention; challenges modest community interventions and extends evidence for larger risk factor changes.

Multifactorial trial in the prevention of coronary heart disease: 3. Incidence and mortality results

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Multifactorial trial in the prevention of coronary heart disease: 3. Incidence and mortality results

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider